Sir,

We read with great interest the article ‘Licence to Save: a UK survey of anti-VEGF use for the eye in 2015’.1 It is a particularly pertinent and well-timed article given the recently declared ‘crisis’ the NHS is experiencing. We are writing to highlight the potential influence this article may have now that the ‘Getting It Right the First Time’ (GIRFT; http://www.gettingitrightfirsttime.com) project will eventually extend to subspecialties such as ophthalmology. The GIRFT project was initially piloted in orthopaedics, financially supported by the NHS PCC (Primary Care Commissioning). The GIRFT project is a comprehensive review of service seeking improvement through the careful analysis of existing care pathways, patient experience, waiting times, service costs, cost commissioning, surgical targets, and outcomes, with the aim of developing a more standardized improved national service (http://www.gettingitrightfirsttime.com/downloads/GIRFT-National-Report.pdf). It will be interesting to see if this service review in ophthalmology will impact on drug licensing and our current anti-VEGF practices.